Is Evidence-Based Nursing Practice an Attainable Goal?
Article first published online: 21 MAR 2006
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Volume 35, Issue 2, page 165, March 2006
How to Cite
Lowe, N. K. (2006), Is Evidence-Based Nursing Practice an Attainable Goal?. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 35: 165. doi: 10.1111/j.1552-6909.2006.00023.x
- Issue published online: 21 MAR 2006
- Article first published online: 21 MAR 2006
For three years, JOGNN has published a regular feature “Resources for Evidence-Based Practice” written by Dr. Carol Sakala. The purpose of this column is to update JOGNN’s readers on the most current evidence available to support decisions about the care of women, mothers, and infants. The decision to include this column in JOGNN was based on the strong beliefs of its editors and editorial advisory board that the principles of evidence-based practice are essential to the provision of high-quality and ethical patient care. I can’t help but wonder whether these columns are making a difference in clinical practice, whether practicing nurses are reading the column, accessing relevant published materials, and making changes in practice based on the information.
Findings from a recent national survey published in the American Journal of Nursing suggest that the nursing workforce does not have the requisite skills for engaging in evidence-based practice (Pravikoff, Tanner, & Pierce, 2005). More than 54% of the 760 clinical nurses who responded to the survey were not familiar with the term evidence-based practice despite its wide discussion in the health care literature for well more than a decade. In addition, although 61% of these nurses reported that they needed to seek information about their practice weekly or more often, 67% of them always or frequently sought the needed information from a colleague. Research reports or articles were never used to support clinical practice by 58% of the nurses, and 82% had never used a hospital library. Further, 76% never searched CINAHL, and 58% never searched MEDLINE.
In addition to the widely reported issue of inadequate time as the most common barrier to the use of research in practice, the most common individual barriers reported by the nurses surveyed were the lack of value for research in practice, lack of understanding of electronic databases such as CINAHL and MEDLINE, difficulty accessing research articles, lack of computer skills, and difficulty understanding research reports. The respondents identified other goals with a higher priority, difficulty in recruiting and retaining nursing staff, and deficiencies in organizational budgets for acquisition of information resources and for staff training in resource use as the most common institutional barriers to the use of research in nursing practice. The researchers concluded, “RNs in the United States aren’t ready for evidence-based practice because of gaps in their information literacy and computer skills, their limited access to high-quality information resources, and above all, the attitudes toward research. These attitudes are reinforced by their perception of organizational priorities” (Pravikoff et al., 2005, p. 50).
The results of this survey and the conclusions of its investigators should be very concerning to nursing leaders and administrators in both clinical practice and education. Nursing faculty at all levels of the educational endeavor must embrace their responsibility to teach the principles of evidence-based practice including the value of research as a basis for practice, the skills to access the research literature and to read and evaluate research reports, and the career-long, professional obligation to remain informed through literature searching. In order to do this, however, nurses who teach must “believe it and live it themselves” (Pravikoff et al., 2005, p. 49). Nurse administrators and clinical leaders such as clinical nurse specialists and other advanced practice nurses must identify and provide the needed resources including technical access and staff development to assure that all nurses are equipped to practice evidence-based care. Changing the organizational climate and value system to make evidence-based nursing practice a core value and priority within the institution may be a more challenging goal requiring unit-based and broad institutional initiatives. Optimally, these efforts would be multidisciplinary in scope. My goal as JOGNN’s editor is that the journal's content is one resource to support evidence-based nursing practice for women, mothers, and infants.